Rawal Harsh, Nakhle Asaad, Peters Matthew, Srivastav Apurv, Srivastav Sudesh, Irimpen Anand
Department of Medicine, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave, Chicago, IL 60657, United States of America.
Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA.
Prog Cardiovasc Dis. 2023 Jul-Aug;79:107-111. doi: 10.1016/j.pcad.2023.07.001. Epub 2023 Jul 6.
Historically, natural disasters have been known to have an effect on humankind including physical and mental health. Studies dating from the early nineteen hundreds have shown repeated associations between different catastrophic natural disasters and its effects on cardiovascular (CV)health, including increased morbidity and mortality. Knowing that these effects on CV health last sometimes up to a decade, we sought to study the effects of hurricane Katrina on incidence of acute myocardial infarctions (AMI) to see if the effects perpetuated and continued or mitigated after the first decade.
Ours is a single center, retrospective observational study at TUHSC to compare the incidence of AMI, chronobiology and other demographic characteristics between the 2-year pre-Katrina and 14-year post-Katrina group. After IRB approval, patients were identified using specific ICD 9 and 10 codes. Data was collected by chart review and stored in secure password protected files. Descriptive statistics including mean, standard deviation and percentages were calculated. Statistical analysis comparing mean and standard deviations were performed using Chi-square test and t-test.
The pre-Katrina cohort saw a 0.7% incidence of AMI, whereas the post-Katrina cohort saw 3.0% incidence of AMI (p < 0.001). The post- Katrina group was also noted to have significantly higher comorbidities including diabetes, hypertension, polysubstance abuse and coronary artery disease.
Even 14 years after the storm, there was a four-fold increase in the incidence of AMI. Additionally, psychosocial, behavioral and traditional risk factors for CAD were significantly higher more than a decade after the natural disaster as well.
从历史上看,自然灾害对人类有影响,包括身心健康。自20世纪初以来的研究表明,不同的灾难性自然灾害与其对心血管(CV)健康的影响之间存在反复关联,包括发病率和死亡率的增加。鉴于这些对心血管健康的影响有时会持续长达十年,我们试图研究卡特里娜飓风对急性心肌梗死(AMI)发病率的影响,以了解这些影响在第一个十年后是否持续存在、继续或减轻。
我们在图兰大学健康科学中心进行了一项单中心回顾性观察研究,以比较卡特里娜飓风前2年和卡特里娜飓风后14年组之间急性心肌梗死的发病率、时间生物学和其他人口统计学特征。经机构审查委员会批准后,使用特定的ICD 9和10编码识别患者。通过病历审查收集数据,并存储在受密码保护的安全文件中。计算了包括均值、标准差和百分比在内的描述性统计数据。使用卡方检验和t检验对均值和标准差进行统计分析。
卡特里娜飓风前的队列中急性心肌梗死发病率为0.7%,而卡特里娜飓风后的队列中急性心肌梗死发病率为3.0%(p < 0.001)。还注意到卡特里娜飓风后的组合并症显著更高,包括糖尿病、高血压、多种物质滥用和冠状动脉疾病。
即使在风暴过后14年,急性心肌梗死的发病率仍增加了四倍。此外,在自然灾害发生十多年后,冠心病的社会心理、行为和传统风险因素也显著更高。